Management of maternal depression: Qualitative exploration of perceptions of healthcare professionals from a public tertiary care hospital, Karachi, Pakistan (original) (raw)
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International Medical Journal Malaysia, 2022
INTRODUCTION: Postnatal depression is largely underdiagnosed in many low-and middle-income countries, including Malaysia. Healthcare practitioners' perceptions towards postnatal depression were identified as one of the main barriers to seeking help. Objective: This study aimed to explore the perceptions of healthcare practitioners about postnatal depression, and their experience in managing women with postnatal depression in Malaysia. MATERIALS AND METHODS: Eighteen healthcare practitioners (5 head nurses, 9 nurses, and 4 doctors) working in maternal and child health clinics and a female psychiatric ward in Kuala Lumpur were individually interviewed following a generic qualitative research design. Interview data were transcribed verbatim, and the transcripts were analyzed using framework analysis. RESULTS: Healthcare practitioners reported that their management of women with postnatal depression was limited by the absence of a specific screening tool, and presence of stigma associated with postnatal depression. DISCUSSION AND CONCLUSION: Healthcare practitioners were found to be aware of poor maternal mental health provision within their clinical setting and are ready to contribute to developing protocols to improve maternal mental health. As its diagnosis and treatments vary from general depression, there should be a specific direction addressed in the policy to assist in actions for managing postnatal depression. Professional training and continuous education on postnatal depression are a fundamental component in fostering quality of care, and public awareness as well as improving stigma within the Malaysian healthcare system.
BMC Psychiatry, 2014
The present study's aim has been to investigate, identify and interpret the views of pediatric primary healthcare providers on the recognition and management of maternal depression in the context of a weak primary healthcare system. Methods: Twenty six pediatricians and health visitors were selected by using purposive sampling. Face to face in-depth interviews of approximately 45 minutes duration were conducted. The data were analyzed by using the framework analysis approach which includes five main steps: familiarization, identifying a thematic framework, indexing, charting, mapping and interpretation. Results: Fear of stigmatization came across as a key barrier for detection and management of maternal depression. Pediatric primary health care providers linked their hesitation to start a conversation about depression with stigma. They highlighted that mothers were not receptive to discussing depression and accepting a referral. It was also revealed that the fragmented primary health care system and the lack of collaboration between health and mental health services have resulted in an unfavorable situation towards maternal mental health. Conclusions: Even though pediatricians and health visitors are aware about maternal depression and the importance of maternal mental health, however they fail to implement detection and management practices successfully. The inefficiently decentralized psychiatric services but also stigmatization and misconceptions about maternal depression have impeded the integration of maternal mental health into primary care and prevent pediatric primary health care providers from implementing detection and management practices.
2019
The World Health Organisation recommends healthcare practitioners to equip themselves with appropriate skills to assess the psychological distress in women attending the antenatal and postnatal healthcare. Nevertheless, little is known about the healthcare practitioners' perceptions of postnatal depression and its management. The aims of this review were: (1) to explore the experiences of healthcare practitioners in caring for women with postnatal depression in different countries and (2) to identify any qualitative study conducted in Malaysia regarding the healthcare practitioners' perceptions of postnatal depression. To achieve these objectives, a qualitative synthesis of studies reporting the healthcare practitioners' experience of managing women with postnatal depression was conducted. A search in CINAHL, PubMed, MEDLINE, PsycINFO and ASSIA databases was performed using specific keywords and published peer-reviewed articles from 2006 to 2016 were screened for inclusion criteria. A total of 15 relevant studies were identified and reviewed. The studies included were conducted in eight different countries: America,
Healthcare Practitioners’ Views of Postnatal Depression: A Qualitative Synthesis
Jurnal Sains Kesihatan Malaysia
The World Health Organisation recommends healthcare practitioners to equip themselves with appropriate skills to assess the psychological distress in women attending the antenatal and postnatal healthcare. Nevertheless, little is known about the healthcare practitioners' perceptions of postnatal depression and its management. The aims of this review were: (1) to explore the experiences of healthcare practitioners in caring for women with postnatal depression in different countries and (2) to identify any qualitative study conducted in Malaysia regarding the healthcare practitioners' perceptions of postnatal depression. To achieve these objectives, a qualitative synthesis of studies reporting the healthcare practitioners' experience of managing women with postnatal depression was conducted. A search in CINAHL, PubMed, MEDLINE, PsycINFO and ASSIA databases was performed using specific keywords and published peer-reviewed articles from 2006 to 2016 were screened for inclusion criteria. A total of 15 relevant studies were identified and reviewed. The studies included were conducted in eight different countries: America,
World journal of psychiatry, 2017
To understand the experience of maternal depression, the factors implicated in accessing health, and the acceptability of the psychosocial intervention. The participants were recruited from the paediatrics outpatient department of Civil Hospital Karachi, Pakistan. The study started in December 2009 and completed in December 2010. Women with maternal depression, aged 18-44 years with children aged 0-30 mo who had received nutritional supplements, and participated in the intervention programme [called Learning through Play (LTP) plus] were included in the study. Qualitative interviews were conducted with 8 participants before the intervention and 7 participants after the intervention. A semi structured topic guide was used to conduct the interviews. Framework analysis procedures were used to analyse the qualitative data. Four themes emerged: (1) the women's contextual environment: Interpersonal conflicts, lack of social support and financial issues being the major barriers in asse...
Frequency of Postnatal Depression in a Tertiary Care Hospital : A Cross Sectional Study
2018
Background: Postnatal depression can affect health of among many mothers. Objective: To assess the frequency of depression among postnatal women in a tertiary care setting of Pakistan. Methodology: Study Design: Cross Sectional Study. Two hundred and fifty Postnatal women were recruited voluntarily through Gynecology and Obstetrics ward Sheikh Zayed Hospital, Rahim Yar Khan, Pakistan. A structured Proforma was prepared and later screened through 10-item Edinburgh Postnatal Depression Scale (EPDS). The results were analyzed through SPSS version 21. Frequency of depression was presented as percentage. Results: The mean age of the postnatal recruited women was 27.5 years. It was noted that 75 (30%) of the Postnatal women were depressed; among Primigravida (28%) and Multigravida (30%) have depression. Poverty, lack of social support, female children only and birth of female child were enlisted as common among the risk factors. Conclusion: The study showed that one third the mothers have...
Sultan Qaboos University Medical Journal [SQUMJ]
Objectives: This study aims to describe healthcare professionals' experience in providing mental health services to women with postpartum depression. Methods: In this qualitative study, data were collected through semi-structured interviews with five physicians, five midwives, and five psychologists from fourteen urban healthcare centers in Kerman, Iran, from April 2019 to September 2019. We used purposeful sampling to select the participants. Data were qualitatively analyzed using a content analysis approach. Results: Data analysis revealed the main theme of the study, "the long way ahead of comprehensive, integrated and responsive mental health services." This theme includes four categories: "postpartum depression challenges, "social and personal factors," "structural challenges," and "need to change in the mental health services." The participants described that the diagnosis of depression is difficult due to insufficient knowledge...
Archives of basic and applied medicine, 2018
Maternal depression is gradually becoming a prevailing condition among women of reproductive age in Nigeria but there are little efforts towards addressing this problem. Need assessment for health education service provision on maternal depression therefore becomes necessary. Hence, this study assessed the needs of Primary Health Care (PHC) workers regarding the provision of routine health talk on maternal depression. This study was descriptive in design and it adopted a mixed method. Four Key Informant Interviews (KII) and a survey which involved 100 Health Workers (HWs) were carried out. KII participants were purposively selected from the 4 LGAs where volunteers were found and the 100 HWs were conveniently selected from all the Comprehensive Clinics (CCs) in the 5 LGAs. A KII guide and structured questionnaire were used to collect data and data were analyzed thematically, with descriptive statistics and chi-square. The mean age of the key informant's interviewees was 54±6.1yea...
BMC Family Practice, 2009
In the UK, 8-15% of women suffer from postnatal depression with long term consequences for maternal mood and child development. Current guidelines state that health visitors and GPs should continue to have a major role in the detection and management of postnatal depression. Previous literature suggests that women are reluctant to disclose symptoms of postnatal depression. This study aimed to explore general practitioners' (GPs), health visitors' and women's views on the disclosure of symptoms which may indicate postnatal depression in primary care.
2019
BackgroundMaternal mental health is an international public health concern. Many women experience mental ill-health during and after pregnancy, but assessment is not part of routine maternity care in many low- and middle-income countries. Healthcare providers are in a position to identify and support women who experience mental health disorders during and after pregnancy. We sought to investigate the knowledge, attitudes and perceptions of routine screening for maternal mental health during and after pregnancy among healthcare providers providing routine maternity care in Accra, Ghana. Enabling factors, barriers and potential management options to routinely screen maternal mental health during and after pregnancy were explored.MethodsSemi-structured key informant interviews (n = 20) and one focus group discussion (n = 4) were conducted with healthcare providers working in one public hospital in Accra, Ghana. Transcribed interviews were coded by topic and then grouped into categories...